At the general ward of a Cuttack hospital, Tulasi Hembram, 35, struggles to respond to doctors' questions. Her five-year-old daughter, admitted on March 21 with 'gross development delay' and barely weighing 6 kg, lies listlessly on the bed. Days earlier, on Sunday, Tulasi's 10-year-old son had died at home, with doctors yet to arrive at a conclusion on what may have caused the death. Amid reports that Tulasi's son died allegedly of 'malnutrition' and with her daughter now fighting for her life at Cuttack's SVP Post Graduate Institute of Paediatrics, doctors treating the five-year-old said they suspect the child has “secondary malnutrition”, where the body refuses to adequately absorb energy as a result of other medical conditions. Senior doctors suspect both the five-year-old and her brother, who died earlier this week, probably suffered from a congenital disorder. Hospital superintendent Jnanindra Nath Behera said the child is so weak that they cannot risk running tests on her to diagnose her condition. “We suspect it is a case of secondary malnutrition. At age 5, she weighs only 6.3 kg. She is extremely weak and has to stay under observation for a few weeks. Her mother is also not able to say much about her. We are trying to win her confidence gradually so that she is comfortable letting us know her daughter's history,” Behera told The Sunday Express. Dr Sibasish Maharana, Chief District Medical Officer at Jajpur, where the five-year-old was first admitted, said, "We suspect the child suffered from cerebral palsy, but doctors need to run more tests to confirm that. She has secondary malnutrition, which arises when an individual gets an adequate diet but energy is not adequately absorbed by the body due to a medical condition.” Speaking to The Sunday Express, Tulasi, a resident of remote Ghatisahi village, in Danagadi block of chromite-rich Jajpur district, around 90 km from Cuttack, said, “The child is unable to even sit or walk.since birth. She lies on the floor all the time, not even able to eat properly.” Tulasi has travelled this far from home for the first time in her life. After news of Tulasi's son's death reached the district administration, they moved to get her five-year-old admitted to the Jajpur district hospital, from where she was referred to Cuttack. The administration has sent Tulasi's five other children - barring her eldest daughter and a nine-month-old, who have accompanied her to the hospital - to the Nutrition Rehabilitation Centre (NRC) at Sukinda, around 30 km from their village. Her husband, Banku, is a daily-wage worker. According to a Food Supplies and Consumer Welfare Department official at Danagadi block, while the family has a ration card, for the last six months, they have not been getting grains under the National Food Security Act (NFSA). “They used to get 15 kg rice (5 kg per head) since only three names were enrolled (in the ration card). But they were deprived of even this due to the mischief of a local retailer, who was suspended in January,” the official said on the condition of anonymity. According to this official, the process of appointing a new retailer has been completed and names of Tulasi, her husband and their eight surviving children have been enrolled. “They will soon receive foodgrains under NFSA,” the official said. A senior district administration official said they have already started a survey to identify the children affected by malnutrition and to admit those children to the Nutrition Rehabilitation Centre or to provide supplements at their doorsteps.
